Breast self-examination, or BSE, is a screening tool for cancer. In this procedure, women undergo a systematic review of their breasts to look for lumps. While once universally recommended for the prevention of breast cancer, the role of BSE has become controversial as it has not been shown to reduce mortality. Current recommendations by the U.S. Preventative Service Task Force favor regular mammography in women over 40.
Advantage: Get to Know Your Body
While some of the benefits of BSE are questionable, breast self-examination is a free and easy way to look for cancer. BSE can be done in the privacy of one's own bathroom. According to MayoClinic.com, the focus of BSE is now on increasing self-awareness. Women should be familiar with the normal consistency of their breasts and the tissue underlying them.
Advantage: Supplement to Mammography
Mammography is not a perfect science, and even with the best technology and radiologists, some breast lumps can be missed. This can be because they do not cause any noticeable changes on X-rays. Regular breast self-examination might be able to pick up these masses. As Dr. Susan Orel of BreastCancer.org notes, "mammography misses at least 10 percent of breast cancer. So if you feel a lump that doesn't show up on a mammogram, bring it to your doctor's attention. Get it evaluated."
No Detection Advantage
While breast self-examining has long been touted as a way to identify cancer, it has not stood up to scientific rigor. A meta-analysis published by the "Cochrane Collaboration" in 2008 looked at two major studies of breast cancer in China and Russia; the number of women involved was greater than 380,000. This study showed that patients with regular breast examination did not have better detection rates than those who did not.
Disadvantage: Excessive Biopsies
Women who undergo regular breast self-examination often undergo excessive biopsies. A study published in 2001 in the "Canadian Medical Association Journal" found that women who regularly examined their breasts were nearly twice as likely to undergo benign biopsies. Excessive biopsies can cause emotional problems and disfigurement of the breast. Most importantly, scarring of the breast could prevent early detection of a future malignancy in that region.
Current Recommendations
In the light of recent research, the role of BSE in early detection of breast cancer is questionable. The Conchrane Collaboration concludes that "at present, screening by breast self-examination or physical examination cannot be recommended." The U.S. Preventative Service Task Force also recommends against screening. The American Congress of Obstetricans and Gynecologists, however, still recommends monthly BSE.
References
- MayoClinic.com Breast Exam
- US Preventative Services Task Force: Breast Cancer Screening; December 2009
- BreastCancer.org; Breast Self-Exam; December 2008
- "Cochrane Reviews"; Regular Self-Examination or Clinical Examination for Early Detection of Breast Cancer; J.P. Kösters et al.; 2008
- "Canadian Medical Association Journal"; Should Women be Routinely Taught Breast Self-Examination to Screen for Breast Cancer?; Nancy Baxter; June 2001
